Hair-Based Biomarkers in Female Reproductive Health as Chronic Stress Biomarker: Current Evidence and Emerging Insights

This review discusses the role of hair cortisol concentration (HCC) and the cortisol:DHEA ratio as biomarkers for chronic stress in female reproductive health. These biomarkers provide a long-term record of hormone exposure and are linked to various reproductive health issues. Evidence shows that hair cortisol levels increase during pregnancy and decrease after birth, have inconsistent associations with postpartum depression, are higher in women with polycystic ovary syndrome (PCOS), and are associated with lower success rates in in vitro fertilization (IVF). The review emphasizes the need for region-specific norms, particularly in India, due to unique social and economic factors affecting stress and reproductive outcomes. While hair biomarkers offer a promising noninvasive method for stress assessment, the review calls for standardized methods and larger regional studies to enhance their clinical utility.